When you’re there in body, but not in mind


Greet­ings WSNA members! My name is Jessica Rainbow, and I wanted to thank the many WSNA members who answered the call to partic­i­pate in my disser­ta­tion study on nurse presen­teeism in the fall of 2017. Presen­teeism is when someone is physi­cally at work, but not fully engaged or performing. I became inter­ested in presen­teeism due to my own experi­ences with burned out and sick coworkers as an ICU nurse and after inter­viewing nurses about their fatigue while a nursing PhD student. As nurses, we have a lot going on both at work and outside of work, and these things (like our work environ­ment and our own health and well-being) can affect our ability to be fully present at work. 

Presen­teeism in nursing has been linked to negative outcomes for patients, nurses and health care organi­za­tions. Missed patient care, falls and medica­tion errors have all been linked to presen­teeism in prior studies (Cassie, 2014; Dhaini et al., 2016; Letvak, Ruhm, & Gupta, 2012). In studies that have looked at presen­teeism across profes­sions, nurses have been found to have the highest rates. However, there are limited studies on what leads to presen­teeism among nurses, and we don’t know what the best way is to measure presen­teeism. So, for my disser­ta­tion study, I did a survey that compared different existing presen­teeism measures and assessed what leads to presen­teeism and what the conse­quences of presen­teeism are. 

I recruited nurses from around the country through social media, nursing organi­za­tions like WSNA and hospi­tals. Specif­i­cally, I recruited nurses who worked in hospi­tals providing direct patient care. A total of 447 nurses from 40 different states partic­i­pated in the survey. On average, nurses had 11.3 years of experi­ence, worked 34 hours per week and were 39 years old. Presen­teeism rates on our survey were higher across measures that looked at presen­teeism due to sickness, job-stress and workplace violence than in previous studies. We found that there was a connec­tion between negative work environ­ment, lower profes­sional values as described in the ANA’s Code of Ethics, higher perceived stress and work-life imbal­ance and higher presen­teeism. Presen­teeism was linked to lower profes­sional quality of life, higher turnover inten­tion and more missed patient care. 

These findings indicate that presen­teeism is a more preva­lent problem than previ­ously thought, that multiple factors can contribute to presen­teeism, and that there are conse­quences for nurses, health care organi­za­tions and patients. Nurses should be aware of their own poten­tial presen­teeism during a shift and think about presen­teeism and its conse­quences when deciding to attend work when not at their best. Nurse leaders should consider presen­teeism and its associ­ated conse­quences when making decisions about employee policies (e.g. manda­tory overtime.) As a researcher, I am working to learn more about how to measure presen­teeism and how to inter­vene to address the issues leading to presen­teeism (like work environ­ment and stress) and presen­teeism itself. 

Thank you again to all those who partic­i­pated in my survey — your responses provide a baseline from which we can build going forward and future direc­tions for my research. If you are inter­ested in learning more about nurse presen­teeism and my research, you can contact me via email at or follow me on Twitter @JessicaGRainbow.